Colds and flu

14 September 2009

H1N1 warning to pregnant women

Health authorities issued a renewed warning to pregnant women as the total of confirmed South African swine flu deaths reached 18.

Health authorities issued a renewed warning to pregnant women as the total of confirmed South African swine flu deaths reached 18.

Nine of the dead were pregnant women, most of whom had been in the last third of their pregnancies, the National Institute for Communicable Diseases said in a statement.

The institute said pregnancy had been identified as a particular risk factor for severe swine flu.

"It is critical that pandemic influenza A H1N1 infection should receive particular attention in any pregnant woman with influenza-like illness (fever, muscle pain and/or dry cough)," it said. "In the earlier stages of pregnancy the decision to treat must be made by the doctor based on the clinical condition of the patient.

"In the second and especially the third trimester of pregnancy, urgent treatment should be considered with the appropriate antiviral drugs particularly if there is any sign of pneumonia (shortness of breath) and prior to any laboratory testing and results being received."

Routine testing for everyone not ideal
The institute added however that most swine flu cases in South Africa remained mild and "self-limiting".

Routine H1N1 testing for everyone with flu-like illness was still not recommended. Nationwide, there had been 5 118 laboratory-confirmed cases of swine flu.

"The likelihood of influenza-like illness being due to the pandemic influenza strain is very likely at this moment because of the widespread outbreak which appears to have replaced the seasonal influenza," it said.

A laboratory test was not necessary to guide treatment.

The institute's statement was echoed by Eastern Cape health department spokesman Sizwe Kupelo, who appealed to residents of the province not to demand testing through private doctors.

Not only was this an unnecessary expense -- it would cost about R800 -- but it put huge strain on testing facilities that were needed for patients at real risk, such as pregnant women.

The province had given instructions that people with flu symptoms visiting public health facilities should jump the queue, so they could be treated quickly and sent home to rest for the recommended seven days.

’people must trust us’
He said an unfortunate consequence of the province's swine flu awareness campaign, which included pamphlet distribution at taxi ranks, was that people visiting clinics were now rattling off a list of symptoms that they did not necessarily have.

"We call on people to trust us. If there is a crisis, we will be the first to say so," he said.

There have been two confirmed swine flu deaths in the province. Kupelo said specimens from two other suspected swine flu deaths had been sent for analysis. – (Sapa, August 2009)

Read more:
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Dr Heidi van Deventer completed her MBChB (Bachelor of Medicine and Bachelor of Surgery) degree in 2004 at the University of Stellenbosch.
She has additional training in ACLS (Advanced Cardiac Life Support) and PALS (Paediatric Advanced Life Support) as well as biostatistics and epidemiology.

Dr Van Deventer is currently working as a researcher at the Desmond Tutu Tuberculosis Centre at the University of Stellenbosch.

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